Analysis of 50 patients with atypical odontalgia. A preliminary report on pharmacological procedures for diagnosis and treatment.
Atypical odontalgia is a distressing and unusual chronic orofacial pain condition. It is often difficult to diagnose because it is associated with a lack of clinical and radiographic abnormalities. The condition is poorly understood on a pathophysiological basis, and patients often undergo repetitive and unnecessary dental procedures in attempts to alleviate pain. In this study, 50 patients diagnosed with odontalgia were evaluated by pharmacological procedures, including topical anesthetic application and phentolamine infusion. Results of these pharmacological procedures suggest that atypical odontalgia is a neuropathic pain of the oral cavity that may have a component of sympathetically maintained pain. Therapeutic trials of topical capsaicin were carried out to assess its efficacy for pain reduction. Topical capsaicin was effective in most patients.
Vickers
E R
ER
Pain Management and Research Centre, University of Sydney, Royal North Shore Hospital, Australia.
Cousins
M J
MJ
Walker
S
S
Chisholm
K
K
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002211:Capsaicin / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005157:Facial Pain / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010646:Phentolamine / Q000008:administration & dosage; D011318:Prilocaine / Q000008:administration & dosage; D012019:Reflex Sympathetic Dystrophy / Q000150:complications / Q000188:drug therapy; D012737:Sex Factors; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D013565:Sympatholytics / Q000008:administration & dosage; D013705:Temporomandibular Joint Disorders / Q000150:complications; D014098:Toothache / Q000188:drug therapy* / Q000209:etiology
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D013565:Sympatholytics; D011318:Prilocaine; D008012:Lidocaine; D002211:Capsaicin; D010646:Phentolamine